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On the Presidential AIDS Advisory Panel Report from South Africa
5 April 2001
In 2000, the President of South Africa invited a number of scientists of different backgrounds and different views
to serve on a panel to discuss HIV/AIDS. The panel met on two occasions in May and July in South Africa and
exchanged views in an Internet discussion during the two months in between. A total of 52 scientists participated
in these discussions.
The main terms of reference were:
What causes the immune deficiency that leads to death from AIDS?
What is the most efficacious response to this cause or causes?
Why is HIV/AIDS in sub-Saharan Africa heterosexually transmitted while in the western world it is said
to be largely homosexually transmitted?
What is the role of therapeutic interventions in the context of developing countries?
The discussions above should be underpinned by considerations of the social and economic context,
especially poverty and other prevalent co-existing diseases and the infrastructural realities of developing
The report released on 4 April 2001 summed up the interventions and discussions that took place.
The most striking factor during all discussions was a division into two groups:
Those scientists who put forward arguments in favour of HIV as being necessary and sufficient to cause
AIDS. AIDS, in turn, leads necessarily to death and therefore has to be treated with antiretroviral drugs.
Those scientists who put forward arguments for HIV not being the cause of AIDS, for AIDS being an
artificial list of old, well known and treatable diseases and anti-retrovirals as being toxic and in part
responsible for people suffering and dying from what is called AIDS.
It was the first time in the history of HIV/AIDS that scientists from different views were invited with the intention
of finding common ground.
The individual interventions and arguments will not be repeated in this summary as they have been published
already. Instead, the recommendations and conclusions will be cited together with a short analysis.
1. Aetiology and transmission of AIDS
Arguments and views were divided and no mutual conclusion could be reached.
A surprising "General recommendation" is given at the end of this chapter: "There was general consensus on the
need for the case definition of AIDS to be standardised for clinical practice in South Africa." This
recommendation was necessary because no clinical guideline for the diagnosis of AIDS in South Africa was
presented to the panel. Only the Health Ministry’s reporting form for AIDS cases was available. AIDS is
defined in this form on the basis of unspecific criteria like fever, diarrhoea and weight loss. An HIV-test is only
optional. (This definition is based on the so-called Bangui-definition of WHO.)
Another surprising aspect was the lack of data. Or as the report puts it: "The deliberations of the panel were at
all times bedevilled by the absence of accurate and reliable data and statistics on the magnitude of the AIDS
problem or even HIV prevalence in South Africa. Repeated requests for such data and statistics, particularly by
panellists who refuted the causal link between HIV and AIDS, failed to result in the provision of such data by
either South African panellists or the officials of the Department of Health."
Therefore the following general recommendation was given: "to collect the data and develop reliable and
up-to-date statistics on the magnitude of AIDS and prevalence of HIV in South Africa".
A good example of the underlying problem is given in the report itself. At the end of the last meeting, Dr.
Makgoba presented statistics on mortality in SA from 1990 to 1999. These data showed a steady and linear
increase of mortality, especially in the age-group 20-60 years. This increase is in parallel to the increase of
HIV-positive results in the antenatal screening during the same period. Dr. Makgoba presented these data as
proof of an AIDS-epidemic – but his interpretation ignors the widely believed concept of an average incubation
period of 8-10 years. If anything, these data would indicate that HIV cannot be made responsible for an
increased mortality during that period. Unfortunately there was no discussion on these data as they were not
made available to the other members of the panel and were presented only at the end of the last meeting.
Dr Makgoba’s interpretation on this very basic subject is further complicated by comments from Statistics South
Africa, which said: " Stats SA has several problems with this interpretation". It concluded on the age-specific
mortality that "the 1999 profile is not a drastically new profile as portrayed."
However, Statistics South Africa is well aware of the real problems in the country: "the largest proportion of
causes of death among males was unnatural causes. The breakdown shows that 27% of South African males die
of accidents and violent deaths."
Statistics South Africa argued that the data from 1990 cannot be compared with 1999, as dramatic changes had
taken place during that period. (i.e. Former Homelands were included in the statistics only after 1994 and the
age distribution of the population had changed over time being demographically younger now.)
3. HIV tests and their accuracy
The report writes: "The key issue that came under focus was the reliability of the ELISA testing. ... A major
recommendation arising from the two meetings was to apply a series of HIV tests of increasing stringency in
order to establish the validity, veracity, rigour, reliability and concordance of ELISA, PCR and viral isolation."
It seems surprising to start studies on the reliability on HIV-test when they have been used for more than 15
years. Therefore it is safe to conclude that the decision to conduct studies to investigate the reliability was made
because they had not yet been done.
(All predictions on HIV and AIDS in South Africa are based on a sentinel screening in public antenatal clinics.
One single ELISA test is used in this screening to diagnose HIV-infection.)
4. Treatment of AIDS
The views were strongly divided on the need and danger of so-called anti-retroviral drugs. Nevertheless the
report concludes: "The toxicity of anti-retroviral drugs was not in dispute from any of the panellists."
5. Preventive and Prophylactic Measures
Any recommendation on this subject is based on the understanding of the aetiology and the understanding of the
nature of HIV and AIDS. The views and arguments on both sides were diametrically opposed. No general
conclusion could be reached on this subject.
The panel was invited to discuss possible reasons and the magnitude of the HIV/AIDS epidemic in South Africa
– and to make recommendations on how to combat it.
General agreement was reached on the following major problems:
Lack of reliable data. Neither the SA health authorities nor the South African panel members presented
data which indicated an increased mortality, not to mention an AIDS epidemic.
Lack of data concerning the reliability of HIV-testing. It was decided to undertake studies to assess
the reliability of the HIV-tests, especially the so-called ELISA test, because it is the most frequently used
test in SA. (All predictions on HIV and AIDS in South Africa are based on a sentinel screening in public
antenatal clinics. One single ELISA test is used in this screening to diagnose HIV-infection.)
Lack of a reliable definition for AIDS. Three symptoms out of a list of unspecific clinical symptoms are
used in the Ministry of Health’s reporting form for AIDS. (I.e. Fever, diarrhoea, weight loss, general
itching, coughing etc. An HIV-test is optional in the diagnosis of AIDS. This definition is known as the
Bangui definition and was accepted by WHO in 1985.) No other document was presented to the panel
showing the definition of AIDS used by doctors in South Africa. The following recommendation was
therefore decided: "There was general consensus on the need for the case definition of AIDS to be
standardised for clinical practice in South Africa."
Therefore any recommendation concerning treatment or prevention has to be discussed on the basis of a
complete lack of basic data. The panel was not provided with any reliable data whether there is a problem at all
and on it’s magnitude. This is especially worrisome when it comes to the use of so-called antiretroviral drugs. It
should be recalled that the report writes: "The toxicity of anti-retroviral drugs was not in dispute from any of the
The following questions arise after reading the report: Why is it that we ask these very basic questions only after
almost 20 years of AIDS-hysteria? And what did we do during this time when we fought against "HIV/AIDS"?
Christian Fiala MD, Department of Obstetrics and Gynaecology, General Public Hospital Korneuburg,
Ettiene de Harven Prof. emerit (Pathology) Univ. of Toronto, Canada <firstname.lastname@example.org>
Peter Duesberg Prof., Dept. Mol. & Cell Biol. Stanley Hall UC Berkeley
Claus Koehnlein MD, Specialist in Interne Medicine, Kiel, Germany <Koehnlein-Kiel@t-online.de>
Heinz Spranger Univ.-Prof.a.D.Dr.Dr.h.c., German Association of medical and non-medical health
Practitioners (Aktions-Kreis Heilberufe in Deutschland). <IPOM.Spranger@t-online.de>
All are invited members of the South African Presidential Aids Advisory Panel
PRESS RELEASE FROM THE GROUP
6 April 2001
The Group For the Scientific Reappraisal of AIDS Welcomes and Endorses Panel Report from South
"The spirit of liberty is the spirit that is never too certain that it is right."
-- Former Supreme Court Justice Learned Hand
This week's release of the long awaited Presidential AIDS Advisory Panel Report from South Africa represents
an historic turning point that The Group For the Scientific Reappraisal of AIDS has been fighting for since its
inception a decade ago.
The group was formed in 1991 by former Harvard biologist Dr. Charles Thomas who, along with many other
eminent scientists, felt the need to formally oppose the totalitarian nature of the AIDS discourse, and its tragic
consequences on the lives of millions of people around the world.
Since the 1984 press conference at which HIV was declared by the United States Government to be the
"probable" cause of AIDS, the mass media has cemented the impression that the scientific consensus to this
hypothesis was total. In fact there has been considerable and formidable disagreement from many corners of the
scientific community, most famously from UC/Berkeley virologist Dr. Peter Duesberg, whose name has become
equated with dissenting points of view.
Scientists who initially shared Duesberg's critical viewpoint soon found themselves subject to extreme forms of
censorship and professional punishment resulting from their departure from the orthodox view. The (then titled)
Group For The Scientific Reappraisal of The HIV-AIDS Hypothesis came into existence as a group of
signatories of an open letter to the scientific community.
The letter, (dated June 6, 1991) was submitted to every major scientific journal, including Nature, Science, The
Lancet, and The New England Journal Of Medicine. All refused to publish it. In 1996, The Group was finally
able to get a letter published in Science. The original letter read as follows:
To the editor:
It is widely believed by the general public that a retrovirus called HIV causes the group of diseases
called AIDS. Many biochemical scientists now question this hypothesis. We propose that a
thorough reappraisal of the existing evidence for and against this hypothesis be conducted by a
suitable independent group. We further propose that critical epidemiological studies be devised and
Although the popular media persists in depicting the challenge to the main paradigm as insignificant, and claims
that the evidence for HIV as the cause of AIDS is "overwhelming," the new report from South Africa provides
far-ranging data that substantiate many concepts and ideas advanced by The Group.
Over 2000 signatories have lent their names to this dissent, including two Nobel Laureates Dr. Walter Gilbert
and Dr. Kary Mullis. The overwhelming majority hold Ph.D. degrees in various scientific disciplines, from
virology and epidemiology to biochemistry and medicine.
We take delight in noting the irony that The Group's lofty goal of open scientific discourse was finally realized in
South Africa, a country long known as the home of "apartheid" but recognized today as a beacon of hope and
promise as the "rainbow nation."
President Thabo Mbeki has prevailed in his quest for a fuller, deeper understanding of the complex cause or
causes of AIDS, despite the near-hysterical protests from mainstream AIDS activists, the research
establishment, and the media. This week, an interim report was released, documenting the arguments made by
both the conventional viewpoint and the dissidents who comprised the 60 member panel. This panel met twice in
South Africa, and engaged in an internet debate that was distilled into the 132 page report which was released
on April 4th.
While the report does not reach a definitive conclusion over whether or not HIV causes AIDS, it is nonetheless
a victory for those who have insisted upon scientific discourse as the only path to real solutions to the AIDS
crisis. The report lends credence to the very questions the dissidents have insisted be brought to light since
These questions stem from the core question: Does HIV Cause AIDS? Using dispassionate, scientific language,
the report concedes that this question remains unanswered, and that the orthodox contention that the evidence is
"overwhelming" is unfounded. The report fulfills the original goals expressed in the Group's 1991 letter which
stated that "the only way of generating the answers is to carry out proper scientific investigations."
All ten experiments proposed by AIDS dissidents on the panel were endorsed for funding by the South African
Cabinet. Upon completion, these experiments will at long last answer fundamental questions about:
* HIV's alleged pathogenic effect (its role in AIDS)
* The accuracy of the widely used HIV tests which cross react with a range of other non-HIV microbes
endemic to Africa, including those for malaria and TB, as well immunological factors detectable among pregnant
* The extraordinary lack of reliable figures on HIV or AIDS on the continent of Africa, where the Global
Burden of Disease Study (1996) estimated that only 1.1% of death statistics were accurate.
* The unexplained yet vitally important impact of heightened levels of poverty, malnutrition, unclean drinking
water, improper sanitation, and other non-viral challenges that cause significant increases in sickness and death in
Africa, where many deaths are now routinely attributed to AIDS or are called AIDS-related.
* The toxic effects of AIDS drugs which by themselves can be lethal.
The Group expects that the media will predictably treat the prudent and balanced South Africa report with its
usual mix of moral condemnation and disdain for the facts. They will do so under the guise of protecting the
public from information deemed "dangerous." We consider information to fall into two categories: true or false. It
follows from that principle that the only dangerous information is that which is false. In that spirit, we applaud the
courage of President Mbeki and his ministers who have reminded us all of the true meaning of freedom and
We hope that members of the media will scrutinize the South African AIDS Report, re-examine their core
beliefs about HIV and AIDS, and fulfill the core mandate of the journalistic ethic which is to check all sides of
the story, and to report the facts as they find them.
We are ready to assist in this process any way we can.
In conclusion, The Group for the Scientific Reappraisal of AIDS reaffirms and reiterates its mission statement:
1) To develop, articulate, and promote rational scientific discourse on the subject of HIV and AIDS.
2) To advocate the absolute right for students, professors, physicians, scientists, government officials, and
everyone else to think freely and speak openly on the subject of HIV and AIDS without fear of professional,
social, political, economic, or criminal penalties.
3) To assemble scientists, physicians, and other informed people who support these views, and make them
available for commentary and consultation to interested social groups, media outlets, government agencies,
professional organizations, and individuals.
Contact: Celia Farber (Press Secretary) (212) 803-5185, CIFarber@aol.com
The full AIDS Advisory Panel Report can be found at: www.aidspanelreport.com
Visit our website at: www.RethinkingAIDS.com